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HomeMy WebLinkAboutX2020-2904 - Permit Applicationmint Form Wor'kAheeeet for Combo Building & Solar Permit Application @0B City of Newport Beach - Building Division OZ0 . Zq 0 � r Comm'I (X Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Z Grading r -Drainage 7Elec j�XMech P<Plu u cu ', cuvd Fill r Building Address (Not mailing address) r', Flood °fir iq Landslide (-N/A Floor Suite No Project d All��crnzov-� r de(,t Pov4 f? ecxch, CA g265�- ii _ F_ Description of Work Us Const Type #Stories ', Units (if Res) F r' E+� (+ P / CcA bi ✓I e S -� Caua� ISI - � kf%Cht'r1uGcfeo f _` Tle_�_r��y Wall Paich;✓�� / sa,�re _Lc cai�'o.�1 _ New/Add SF[_ Remodel SF Garage/New/Add F — Valuation $ I Od©— Mate a�!l/Labor t OWNER'S NAME Last _ �O First Cri r) er -4 5e FCevy Owner's Address Owner's E-mail Address AIJcw�zcwct _ _I r State Telephone citylJveu)r vk 1?�ec�c1� cjs, ZiP �2G5} Pk*f-G49-2�3+ APPLICANTSNAME Last $r\eC.\I)("f First Applicant's Address Applicant's E-mail Address 2'5i)4 &-win _ S+4 _ VK►�Yli SSG>7 ��,ua�'I. �,( { City State Zip Ci�3C7 Telephone 9r0 7� �//5Z l,Ucojcl CLvJ H�IIS _ er4 p ` ARCHITECT/DESIGNER'S NAME Last �— First—II Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address — City State Zip �— TelephoneF ENGINEER'S NAME Last �- First �— Lic. No.1 Engineer's Address Engineer's E-mail Address City �— State F_ Zip r Telephonel— CONTRACTOR'S NAME/COMPANY -r ceit�tM Lic. No. F6,T)),�6 Class Contractor's Address Contractor's E-mail Address 5352 1CAUv'i'l coAyoll P3 vct #�Z ry pp 11 City Wally vill Oe State cA ZiP QJ60� Telephone g�t)-p3)^�73� V SETBACKS REAR 00 SETBACKS FRONT / (f PERMIT NO. o SETBACKS LEFT 0 f SETBACKS RIGHT �(S- PLAN CHECK NO. USE ZONE �(> SZ' DEVELOPMENT NO PLAN CHECK FEES $